April 2, 2025
(This article was originally written for a client called The Sleep
When you’re suffering from sciatica pain, it can be hard to sleep. Here, doctors share their advice on the best sleeping positions for sciatica.
By Diana Kelly Levey
Sleeping and pain are like oil and water, they just don’t mix well. If you’ve ever tried to get some rest while in pain, you know just how challenging it can be.
One of the most common causes of shooting nerve pain, which people often call “sciatica,” is irritation of one of the nerves as it exits the spine, says Kathleen L. Davenport, MD, physiatrist at Hospitals for Special Surgery in West Palm Beach, Florida. “The nerve can be irritated by different things, but the most common reasons include disc herniation and arthritis.”
It’s important to note that the term “sciatica” is often inaccurate, says Dr. Davenport. When people use the term “sciatica” they usually mean nerve pain that is shooting down their leg. This can be caused by several things, not just “sciatic nerve” irritation.
Someone who has sciatica might also notice pain that goes from the back to the foot, pins-and-needles sensations in the lower extremities, muscle weakness in one or both legs or feet, as well as numbness in one or both legs, according to The Cleveland Clinic.
Causes of sciatica also include tight muscles in the back or hips, spinal stenosis (when the spine narrows), a compressed nerve, injury to the sciatic nerve from a fall or accident, or vertebrae that are out of line.
Your doctor or a physical therapist can diagnose sciatica pain and advise on treatments as well as suggestions on the best sleeping positions for sciatica pain.
Pain, in general, can disrupt sleep, says Dr. Davenport. “This may become a vicious cycle because lack of sleep also can worsen pain. So if someone has nerve pain radiating down their leg, this can make it difficult to fall asleep and/or stay asleep. If someone’s sleep cycle is disrupted, this can then make the nerve pain worse, and the cycle worsens.”
Experiment with several positions to find the one that relieves the pain the best.
“Pain from the back is very positional,” says Dr. Davenport. “This means that one sleeping position is not going to be correct for everyone’s pain. One way the spine may find relief is to lie flat on the back and try to flatten the normal curve of the low back. Oftentimes, this works best with putting a pillow under the knees.”
An opposite way to find relief for sciatica pain is to encourage a little arch in back, says Dr. Davenport. “This may be done by lying flat and allowing the normal arch to happen or by lying on the stomach.”
Side lying can also be attempted if neither of the other two positions work, suggests Dr. Davenport. For side lying, place a pillow between the knees to avoid twisting and to take pressure off of the pelvis.
Sleeping in the fetal position or with a bent-forward position can provide some relief from sciatica pain if you have spinal stenosis. You could also experiment with sleeping in a recliner or an adjustable bed, suggests The Cleveland Clinic.
What works for one person and eases sciatica pain during sleep might not be comfortable for someone else.
“Sleep positions are very personal and I am always surprised when my patients tell me a weird twisted position helps them, so I never say never to a specific sleeping regimen,” says Dr. Davenport. “That being said, allowing your body to twist is often a trigger for pain.”
Here’s how to fix some of the worst sleep positions for sciatica pain.
For side sleepers, that position should include a pillow between the knees and often also elbows, Dr. Davenport suggests.
For front sleepers, check the neck position to make sure this is not causing neck pain.
For back sleepers, ensure the neck is also not twisted and the back is not too arched.
To ease sciatica pain before sleep, try some stretches.
Even some very light core strengthening can help before bed, Dr. Davenport says.
Also, making sure drank enough water throughout the day so you’re not cramming your water intake before bed and needing to up in the night once you’ve finally found a comfortable sleeping position.
Lastly, make sure to have lots of pillows nearby to try under the knees, between the knees, or somewhere else to ensure you’re as comfortable as possible.
Remember to stick to a sleep schedule. This helps regulate your body’s internal clock or circadian rhythm, says Lushun Wang, MD, Senior Consultant Orthopedic Surgeon and Medical Director of Arete Orthopedic Clinic in Singapore. “Go to bed and wake up at the same time every day, even on weekends.”
Limit daytime naps. They can throw off your sleep schedule. “If you must nap, try to limit yourself to about 20 to 30 minutes and make it during the midafternoon,” Dr. Wang suggests.
“If stress or anxiety is keeping you awake, experiment with relaxation techniques such as meditation, deep breathing, progressive muscle relaxation, or talking to a mental health professional,” Dr. Wang suggests.
“Getting to sleep is very important and we can all start to feel a little desperate to sleep when we are in pain,” says Dr. Davenport. This may lead to opening the medicine cabinet and seeking pain relief or a sleep aid, says Dr. Davenport.
Proceed with caution, she suggests. “Please check with your doctor before trying something. If you’re going to take a medication to try to help sleep, take it 30 to 60 minutes before bed and with food and water.
“If possible, try to avoid taking a medication in the middle of the night and then lying back down.”
If you find you are relying on medications to address pain or sleep issues, talk to your doctor to rule out sleep issues like sleep apnea or for a pain treatment otherwise.
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